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21 Cards in this Set

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Medication for HIV
*goal is:
- slow replication of the virus
- suppressing, preventing or stopping opportunistic infections
- boost the immune system
*some MD's hit hard with combo therapy as soon as dx is made, some wait until CD4 levels drop below 500 d/t problems with drug resistence
What is safer sex?
*solitary masturbation
*fantasy
*mutually monogamous relationship with a noninfected partner in which both partners have been negative HIV tests 3 months apart
Other tests
*Quantative RNA Assays-3 types
- RT-polymerase chain reactors (RT-PCR)
- Branched DNA method (bDNA)
- nucleic acid sequence based assay (NASBA)
*all 3 use gene amplification process; 100% specific; used for disease management and to dx HIV
Diagnostic evaluation of HIV tests
*after infection, it takes 3 weeks to 3 months to test positive for HIV antibodies
*ELISA- detects the presence of antibody
*Western Blot- done if ELISA+ detects serum antibodies to 4 specific major HIV antigens; considered + if 2 are present
What kind of isolation is a person with HIV put in?
Blood & body fluid precautions (standard precautions)
What is difference between confidential vs. anonymous test?
Confidential- name is on test
Anonymous- name is not on test (can buy these at Walgreens)
You are stuck with a needle of a patient who has not been HIV tested, what do you do?
*Wash hands (don't squeeze)
*tell manager
*go to ER, get tested, begin viral meds
*explain HIV testing to pt; get dr. order; if pt says 'no' there is nothing you can do
Retrovirus
*they only have RNA and they have reverse transcriptase (RT) an enzyme that makes them more efficient at replicating (1 virus particle can replicate 250 times)
*Retrovirus include: HIV1, HIV2, HTLV 1 (adult T cell leukemia-lymphoma) HTLV II (hairy cell leukemia) HTLV (cutaneous T cell lymphoma)
Lymphocytes
*defend the body- two types
B cells change into plasma cells and secrete antibodies (humoral immunity) T cells attack an antigen directly (cell mediated immunity)
*2 groups of T cells are important in HIV
-T4 cells (CD4 or helper T cells) are vunerable to HIV
-T8 cells (CD8 or supressor T cells) inhibit the immune response
What defines AIDS?
*HIV positive
*CD4+ T-lymphocyte (T4) count below 200/mm3 or
*CD4+ T-lymphocyte total percentage below 14
Immunodeficient people that do not have HIV or AIDS?
oncology pts, elderly, babies
Protease Inhibitors
*they inhibit the activity of HIV protease, an enzyme essential for replication. Inhibiting HIV protease leaves the viral particles non-infectious
*s/e: ^blood glucose and diabetes, fat accumulation, diarrhea, and ^cholesterol
Nucleoside analogue reverse transcriptate inhibitors (NARTI)
*slow the replication of HIV by blocking the RT enzyme. Without RT, the HIV virus does not replicate
*s/e: liver dysfunction, n/v, HA, insomnia, peripheral neuropathy, neutropenia, seizures, lethargy
What is safe sex?
*mutual masterbation
*wearing a latex glove when exploring rectum or vagina
*closed-mouth kissing
*massage
*hugging
*body to body rubbing
Best ward to place HIV/ AIDS on?
oncology...others are already immunosuppressed
Non-nucleoside reverse transcriptase inhibitors (NNRTI)
*inhibit replication of HIV by blocking RT enzyme. By changing the RT it becomes inactive
*s/e: liver dysfunction, HA, rash, dizziness, nightmares, n/v, diarrhea, fatigue, neutropenia
HIV/AIDS, what to assess?
*Immunologic (<WBC, night sweats, fever
*integumentary (poor healing wounds, Karposi's sarcoma, Herpes) *respiratory (Mucous membrnes, candida infections, swollen lymph nodes, sores in mouth, bleeding gums) *gastrointestinal
*CNS (baseline mental status) *opportunistic infections (H. pylori-ulcers) *malignancies (cancers) *AIDS dementia complex (<LOC, confusion)
*wasting syndrome (thin, emancipated)
Opportunistic Infections
*Protozoal infections (pneumocystis carinii pneumonia, toxoplasmosis, cryptosporiosis, isoporiasis) *fungal infections (candidiasis, histoplasmosis, crytococcosis) *bacterial infections (myobacterium avium-intracellulare complex, TB) *viral infections (cytomegalovirus, herpes simplex, varicella-zoster)
Malignancies
*Karposi's sarcoma
*Non-Hodgkins lymphoma
*Hodgkin's lymphoma
*Invasive cervical carcinoma
Therapeutic interventions
*education *drug therapies *comfort
*social isolation *support
*nutrition *skin/mouth care *quality of life
*prevent infections *complementary therapy
*spiritual support *sex education
Other tests
Viral Load Testing - measures the presence of HIV viral genetic material (RNA) or another actual viral protein in the persons blood. Quantitative and very useful in monitoring disease progression and treatment effectiveness